The client has received a heparin infusion for 5 days. Click the laboratory result that requires immediate follow-up.
Hot Spot
Choose your responses, then check the answer.
Explanation
The platelet count fell from 240,000 to 82,000/µL, a decrease greater than 50% during heparin exposure. This pattern requires immediate evaluation for heparin-induced thrombocytopenia.
Quick answer The platelet count fell from 240,000 to 82,000/µL, a decrease greater than 50% during heparin exposure. This pattern requires immediate evaluation for heparin-induced thrombocytopenia.
Why this is correct The platelet count fell by more than half during heparin exposure. That timing and magnitude require prompt evaluation for heparin-induced thrombocytopenia rather than judging the latest value in isolation.
Easy analogy or mental picture Picture the three platelet values as a slope: the clinically important clue is the steep fall across days while heparin is being given.
Memory hook The platelet fall from 240,000 to 82,000/µL is the urgent heparin-associated trend.
NCLEX decision rule When heparin exposure is paired with falling platelets, compare the current count with baseline and timing, then escalate the concerning pattern.
Why the other choices are wrong The aPTT, hemoglobin, and creatinine values answer different monitoring questions; they do not show the marked platelet trend requested.
References
[1]
ASH: Guidelines for heparin-induced thrombocytopenia
Clinical situationThe client has received a heparin infusion for 5 days.
What the nurse should noticeThe platelet count fell from 240,000 to 82,000/µL, a decrease greater than 50% during heparin exposure. This pattern requires immediate evaluation for heparin-induced thrombocytopenia.
Transfer to practiceWhen heparin exposure is paired with falling platelets, compare the current count with baseline and timing, then escalate the concerning pattern.
Heparin-induced thrombocytopenia — An immune-mediated adverse effect associated with thrombosis and falling platelets.
Platelet trend — Change in platelet count over time rather than a single isolated value.